* Indicates required information
Date of Incident *
What was the scam? *
Did you suffer a financial loss? *
Did the imposter ask for payment?
Did you pay the imposter?
Cash payment information
Who did you send your cash payment to?
Where was the cash payment sent?
Shipping method
Wire payment information
Who did you send the wire payment to?
Where did you send the wire to?
Did you provide additional payments?
(Note: Copying and pasting text from external applications may result in errors. Please type the details directly.)
Did you provide personal or sensitive information to the imposter (other than your full name, telephone number, or address)?
Imposter information
Scam Details
(Note: Copying and pasting text from external applications may result in errors. Please type the details directly.)
Your Information
5-digit security PIN *
Please memorize and write down your 5-digit PIN before submiting the form